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Decryption of analyzes

17-OH progesterone: normal, increased and decreased

What it is?

The endocrine system is capable of producing hormones that affect not only the woman's menstrual cycle, but also the state of her health and appearance. Many well-known hormone progesterone, its effect on the second phase of the cycle and carrying a child.

Therefore, when patients first hear about 17-OH progesterone, they have associations with female sex hormones that contribute to the maintenance of pregnancy. But the similarity of the name does not mean that we have an analogue of progestins.

What is 17-OH progesterone is a steroid resulting from the metabolic breakdown of progesterone and 17-hydroxypregnenolone. He belongs to the group of male sex hormones.

17-progesterone

Where does the hormone come from?

  • The adrenal cortex is the main organ that produces this steroid. It is produced by the reticular zone along with the rest of the androgens and affects the development of secondary sexual characteristics.
  • The corpus luteum is a temporary source of formation of 17-OH progesterone, as it appears only after ovulation and functions only for several days.
  • Placenta - is a temporary, but a major source of hormone production. The longer the gestational age becomes, the higher the level of 17-hydroxyprogesterone. Its concentration in the blood decreases sharply only 2-3 days before birth.

Any abnormality of the hormone indicates that one of these organs is not working properly. However, most often the problem is found in the adrenal glands.

How does 17-progesterone differ from progesterone?

Progesterone is a female sex hormone and contributes to the preservation of pregnancy, and also determines the duration of the second phase of the cycle. 17-OH progesterone is a androgen group steroid. Unlike progesterone, it is not an independent hormone, progesterone is its predecessor.

In turn, 17-OH progesterone is the substrate from which testosterone is subsequently formed. That is why violations of the production of these two steroids are in close relationship with each other.

Another difference between 17-hydroxyprogesterone and progesterone is that in the first and second trimesters of pregnancy, a decrease in progesterone level causes fetal death or placental abruption, while a decrease in the breakdown product of this hormone does not have such a large effect on the gestation.

Quite the contrary: a sharp increase contributes to abortion.

Content

17-OH progesterone is elevated - what does this mean?

17-OH progesterone increased

Increased levels of 17-OH progesterone, especially in the follicular phase of the cycle, indicate adrenal dysfunction (if the woman is not pregnant and the steroid is not produced by the placenta).

High concentration indicates that the body is deficient in enzymes involved in the synthesis of steroids - in other words, the doctor can diagnose adrenal hyperplasia.

With this disease, the level of cortisol in the blood gradually decreases, and the level of intermediate products, such as 17-hydroxyprogesterone, increases.

When planning a pregnancy, this aspect should be taken into account, since the accumulation of 17-OH progesterone in the body contributes to enhanced testosterone production, which can lead to a missed pregnancy, retardation of the ovum or miscarriage at a late period, at the end of the second trimester.

17-OH progesterone during pregnancy

Normal during pregnancy, the level of this hormone should increase, as it begins to strongly produce the placenta. Moreover, since the placenta is finally formed only by 15–16 weeks, 17-hydroxyprogesterone begins to rise significantly from this time.

If before conception its level exceeded the norm or stood at the upper limit of the norm, then during pregnancy the doctor should constantly monitor the production of all androgens in the patient, periodically prescribing her a blood test from a vein.

Elevated 17-OH progesterone during pregnancy should be reduced, but there are different opinions among doctors about which drugs to do.

Dexamethasone is considered the main remedy, but some gynecologists and endocrinologists believe that its use is harmful to the fetus, although there is still no substantial evidence that this hypothesis is correct.

To monitor the indicators of 17-OH progesterone is necessary not only for pregnant women, but also for those women who are in reproductive age. Timely prescribed treatment for abnormalities will help avoid serious future health problems.

Decreased 17-OH progesterone

A decrease in the level of the hormone is associated with primary insufficiency of the adrenal cortex, which is called Addisson's disease. This pathology is rare, it is asymptomatic for a long time, however, an addissonic crisis is an extremely life-threatening condition.

Normally, a decrease in the hormone can be observed several days before the onset of labor, when the functions of the placenta are gradually quenched. The female reproductive system suffers from an insufficient concentration of 17-OH progesterone in the blood, even though it belongs to the group of male hormones.

Menstruation becomes irregular, ovulation - rare, intermenstrual bleeding.

Rules for sampling analysis

Hormone surrenders on 3 - 5 day from the moment of the beginning of monthly. Blood will be taken from a vein, it is necessary to come to the treatment room strictly on an empty stomach.

The last evening meal should be no less than 10-11 hours before blood sampling. Otherwise, the hormone indicators will be changed upwards, and the doctor mistakenly takes this for a symptom of adrenal cortex dysfunction.

On any other day of the menstrual cycle, the results of the analysis will be only partially informative, although the norms exist for both the follicular and luteal phases. The results of laboratory studies will be ready no earlier than in three days.

It is better to take 17-OH progesterone along with other hormones that must also be tested on days 3–5 of the menstrual cycle: estradiol, prolactin, testosterone, LH and FSH. It will be expensive, but it will help the doctor to more thoroughly understand the situation and prescribe the necessary hormonal correction.

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